title: Etiological spectrum of hypokalemic paralysis: A retrospective analysis of 29 patients.
abstract: BACKGROUND
  Hypokalemic paralysis is characterized by episodes of acute muscle weakness associated with hypokalemia. In this study, we evaluated the possible etiological factors in patients of hypokalemic paralysis.
  
  
  METHODS
  We reviewed the records of 29 patients who were admitted with a diagnosis of hypokalemic paralysis. Modified Guillain-Barre´ Syndrome disability scale was used to grade the disability.
  
  
  RESULTS
  In this study, 15 (51.7%) patients had secondary causes of hypokalemic paralysis and 14 patients (42.3%) had idiopathic hypokalemic paralysis. Thyrotoxicosis was present in six patients (20.6%), dengue infection in four patients (13.7%), distal renal tubular acidosis in three patients (10.3%), Gitelman syndrome in one patient (3.4%), and Conn's syndrome in one patient (3.4%). Preceding history of fever and rapid recovery was seen in dengue infection-induced hypokalemic paralysis. Approximately 62% patients had elevated serum creatinine phosphokinase. All patients had recovered completely following potassium supplementation. Patients with secondary causes were older in age, had significantly more disability, lower serum potassium levels, and took longer time to recover.
  
  
  CONCLUSIONS
  In conclusion, more than half of patients had secondary causes responsible for hypokalemic paralysis. Dengue virus infection was the second leading cause of hypokalemic paralysis, after thyrotoxicosis. Presence of severe disability, severe hypokalemia, and a late disease onset suggested secondary hypokalemic paralysis.
authors.affiliation: Department of Neurology, King George Medical University, Uttar Pradesh, Lucknow, India.
authors.forename: Ravindra Kumar
authors.initials: RK
authors.lastname: Garg
authors.forename: Hardeep Sing
authors.initials: HS
authors.lastname: Malhotra
authors.forename: Rajesh
authors.initials: R
authors.lastname: Verma
authors.forename: Pawan
authors.initials: P
authors.lastname: Sharma
authors.forename: Maneesh Kumar
authors.initials: MK
authors.lastname: Singh
keywords: Acute flaccid paralysis; dengue virus; hypokalemia; hypokalemic paralysis